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The SPRINT trial suggests that markers of tubule cell function in the urine associate with risk of subsequent acute kidney injury while injury markers elevate after the injury

Kidney International Jun 08, 2019

Bullen AL, et al. - Researchers examined the associations of measured urine markers of tubular function and injury (neutrophil gelatinase-associated lipocalin [NGAL], kidney injury molecule-1, interleukin-18 [IL-18], monocyte chemoattractant protein-1, and chitinase-3-like protein [YKL-40]) at baseline, with subsequent acute kidney injury [AKI] risk among Systolic Blood Pressure Intervention Trial participants with an estimated glomerular filtration rate (eGFR) under 60 ml/min/1.73m2. Findings revealed the association of lower uromodulin and higher α−1 microglobulin [α−1m] with subsequent AKI, independent of eGFR and albuminuria. No link of any of the five injury markers with eventual AKI was evident. They found longitudinal increments in urine NGAL, IL-18, and YKL-40 in those with AKI vs only one marker of tubule function (α1-m), among 59 patients with intervening AKI in a random subset of 947 patients with repeated measurements.
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